Mortality association between obesity and pneumonia using a dual restricted cohort model
Journal
Obesity Research and Clinical Practice
Journal Volume
14
Journal Issue
4
Pages
350-359
Date Issued
2020
Author(s)
Abstract
Background: An obesity survival paradox has been reported among obese patients with pneumonia. Aims: To determine the impact of obesity on pneumonia outcomes and analyze the correlation between in-hospital all-cause mortality and obesity among patients with pneumonia. Methods: The United States Nationwide Readmissions Database (NRD) was retrospectively analyzed for patients with pneumonia from 2013 to 2014. We used a step-wise restricted and propensity score matching cohort model (dual model) to compare mortality rates and other outcomes among pneumonia patients based on BMI. Mortality was calculated by a Cox proportional hazard model, adjusted for potential confounders with propensity score matched analysis. Results: A total of 70,886,775 patients were registered in NRD during the study period. Of these, 7,786,913 patients (11.0%) were considered obese and 1,652,456 patients (2.3%) were admitted to the hospital with pneumonia. Based on the step-wise restricted cohort model, the hazard ratio comparing the mortality rates among obese pneumonia patients to mortality rates among normal BMI pneumonia patients was 0.75 (95% CI 0.60–0.94). The propensity score matched analysis estimated a hazard rate of 0.84 (95% CI 0.79–0.90) and the hazard ratio estimated from the dual model was 0.82 (95% CI 0.63–1.07). Conclusions: With the application of a dual model, there appears to be no significant difference in mortality of obese patients with pneumonia compared to normal BMI patients with pneumonia. ? 2020
Subjects
Mortality; Obesity; Pneumonia
SDGs
Other Subjects
adult; aged; all cause mortality; Article; body mass; clinical outcome; cohort analysis; comparative study; confounding variable; controlled study; correlation coefficient; data base; disease association; female; hazard ratio; hospital admission; hospital mortality; hospital patient; human; major clinical study; male; middle aged; mortality rate; obese patient; obesity; observational study; pneumonia; priority journal; prognosis; propensity score; proportional hazards model; retrospective study; step wise multiple regression; very elderly; complication; mortality; United States; Body Mass Index; Cohort Studies; Humans; Obesity; Pneumonia; Proportional Hazards Models; Retrospective Studies; United States
Type
journal article